There are actually many reasons a client will avoid using their insurance and self-pay instead.
Why do some therapy clients prefer to self-pay?
- Alternative treatment modalities
One of the biggest reasons is privacy. There is considerable fear of having a behavioral health treatment on one's"permanent record", especially employer-provided health benefits. In reporting services and having to meet requirements of insurance companies, you must be diagnosed with a mental illness requiring treatment. The insurance company uses the diagnosis to decide if therapy is considered "medically necessary" for them to pay for services.
When working directly with clients, all decisions about treatment are between the two of us, not to comply with insurance requirements. We work together to work within the current framework to find what is best for you.
Therapy Appointment Availibility
When you make connection with a therapy provider, there is nothing more frustrating than having to endure your situation for 4-6 weeks waiting for an appointment. Within the framework of working with self-pay choices, there are special appointment times alloted for self-pay clients.
Alternative Treatment Modalities
In the section labeled Specializations, there are additional specializations, independent of just general therapy, that can and will be used without waiting for authorization from your insurance company.
Self-Pay is the tool for all those who want to be in charge of their own mental healthcare and costs.
- As a result of the dramatic reduction inprovider insurance reimbursement rates and the increased costs to clients of network benefits, you are paying most of the fees for our serices.
- Coupes/marital therapy issues: It is important to note that most insurance plans do not cover therapy that is primarily focused on your couple/marital bond because relationship problems are not a diagnosable disorder and, therefore, not a "medical necessity." In many plans, couples/marital therapy is an "exclusion"!
When you pay me the self-pay fee, you can then file for reimbursement. I provide a statement at the end of every month that includes all the inormation you will need to file a claim and send it to the insurer along with one of their claim forms.